{"created":"2023-06-19T10:30:49.967254+00:00","id":2984,"links":{},"metadata":{"_buckets":{"deposit":"e35113a7-b44e-49ca-83da-ef25228b0f27"},"_deposit":{"created_by":31,"id":"2984","owners":[31],"pid":{"revision_id":0,"type":"depid","value":"2984"},"status":"published"},"_oai":{"id":"oai:kwmed.repo.nii.ac.jp:00002984","sets":["1709617079800:35:800"]},"author_link":["130600","130601","130602","130603","130604","130605","130606","130607","130608","130609","130610","130611"],"item_10001_alternative_title_1":{"attribute_name":"その他(別言語等)のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Categorization of consciousness disturbance in the recovery phase after intracerebral hemorrhage-practicality of newly-invented simplified consciousness recovery scale","subitem_alternative_title_language":"en"}]},"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2021","bibliographicIssueDateType":"Issued"},"bibliographicPageEnd":"33","bibliographicPageStart":"23","bibliographicVolumeNumber":"47","bibliographic_titles":[{"bibliographic_title":"川崎医学会誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Kawasaki medical journal","bibliographic_titleLang":"en"}]}]},"item_10001_description_33":{"attribute_name":"記事種別(日)","attribute_value_mlt":[{"subitem_description":"原著論文","subitem_description_language":"ja","subitem_description_type":"Other"}]},"item_10001_description_34":{"attribute_name":"記事種別(英)","attribute_value_mlt":[{"subitem_description":"Regular Article","subitem_description_language":"en","subitem_description_type":"Other"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"川崎医学会","subitem_publisher_language":"ja"}]},"item_10001_relation_14":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"https://doi.org/10.11482/KMJ-J202147023","subitem_relation_type_select":"DOI"}}]},"item_10001_relation_17":{"attribute_name":"関連サイト","attribute_value_mlt":[{"subitem_relation_type_id":{"subitem_relation_type_id_text":"https://igakkai.kms-igakkai.com/wp/wp-content/uploads/2021/KMJ-J202147023.pdf","subitem_relation_type_select":"URI"}}]},"item_10001_relation_35":{"attribute_name":"医中誌ID","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"2022194409","subitem_relation_type_select":"ICHUSHI"}}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00045593","subitem_source_identifier_type":"NCID"},{"subitem_source_identifier":"AN12940574","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0386-5924","subitem_source_identifier_type":"PISSN"},{"subitem_source_identifier":"2758-089X","subitem_source_identifier_type":"EISSN"}]},"item_10001_text_31":{"attribute_name":"著者所属(日)","attribute_value_mlt":[{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学脳神経外科学２"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学脳神経外科学２"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学脳神経外科学２"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学脳神経外科学２"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学脳神経外科学２"},{"subitem_text_language":"ja","subitem_text_value":"川崎医科大学脳神経外科学２"}]},"item_10001_text_32":{"attribute_name":"著者所属(英)","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Department of Neurosurgery 2, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Neurosurgery 2, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Neurosurgery 2, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Neurosurgery 2, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Neurosurgery 2, Kawasaki Medical School"},{"subitem_text_language":"en","subitem_text_value":"Department of Neurosurgery 2, Kawasaki Medical School"}]},"item_10001_textarea_5":{"attribute_name":"抄録(英)","attribute_value_mlt":[{"subitem_textarea_language":"en","subitem_textarea_value":"　Authors newly invented the simplified consciousness rank scale, named “Kawasaki Consciousness Recovery Scale” (K-CRS), by reference to “Coma Recovery Scale-Revised”, which is relatively complicated, but has been widely used for the consciousness evaluation in the chronic recovery phase after cerebral stroke. This scale consists of six ranks in the sequential order, “Coma”,”Vegetative state”,”Minimally conscious state (MCS), lower level”,”MCS, higher level”,”emergence from MCS” and “Conscious state”. In each rank of this scale, several examples often encountered in the actual clinical practice, including facial expressions, are described. The purpose of this study is evaluating the inter-rater differences of this scale. Patients aged 75 or over, having undergone hematoma removal surgery for incidental intracerebral hemorrhage, and ranked as severely disabled with modified Rankin Scale at discharge were enrolled. Eight patients matched the criteria and their medical records were reviewed retrospectively. The raters consist of nine medical professions, three neurosurgeons, three nurses, and three rehabilitation therapists. The raters got the concise explanation of K-CRS and rated the enrolled patients independently. Two patients were rated in the same rank by all raters, and five patients in the same rank by all except one rater. Only two patients were rated differently by more than two raters, and statistically, Kendall’s coefficient of concordance (W) is 0.871 (p < 0.001), indicating the high inter-rater agreement when rating patients with K-CRS. Complete agreement of rating consciousness at discharge may be hard, since the patients manifest the consciousness features ununiformly to each rater in their recovery phase. Still, the rating discrepancy due to errors must be avoided, and for this purpose, more than one raters should review the records and confirm each rank in the retrospective study. In order to avoid the misunderstanding of the scale, relevant medical staffs continue to have regular meetings to achieve common understanding of the scale. With K-CRS, it becomes possible to compare the consciousness levels among patients, thus this simplified scale helps evaluate the effect of neurosurgical intervention, especially for the elderly patients."}]},"item_10001_textarea_6":{"attribute_name":"抄録(日)","attribute_value_mlt":[{"subitem_textarea_language":"ja","subitem_textarea_value":"　脳卒中などの慢性期の意識障害スケールとして利用されている Coma Recovery Scale-Revised（CRS-R）を踏襲して，簡便に障害の程度のランク付けが可能なスケールを日本語で作成し， 川崎意識障害回復スケールと名付けた．これは，昏睡，植物状態，最小意識状態（２段階），最小意識状態から脱した状態，正常意識状態，からなる６ランクのスケールであり，CRS-R には表記されていない具体例を追加し，更に表情もスケールに追加した．これを実際の臨床で用いる際に，ランク付けが観察者間で大きな相違がないかを検証した．75歳以上の特発性脳内出血症例の中で，血腫減圧術を施行し，かつ退院時に modified Rankin Scale で重度の障害（ランク５）と判定された８症例を対象に，退院時意識レベルを後方視的にランク付けした．観察者は医師３名，看護師３ 名，リハビリ療法士３名で，川崎意識障害回復スケールの説明を受けた後で，独立してランク付けを行った．結果は９症例中２症例で全員が同じランク，５症例で１名の観察者のみが１ランク異なったランクを付けており，２名以上が異なるランクを付けたのは２症例で，ケンドールの一致係数Ｗは0.871（p < 0.001）と，観察者が異なっても安定したランク付けになると考えられた．状態の改善期において観察者が同時には改善徴候に気付けないこともあり，ランク付けの相違は完全には防ぐことはできないが，少なくするためには，後方視的研究においてはカルテの見逃しを避けるため に複数の観察者で行うこと，またスケールの理解不足も原因となるが，これを防ぐためには医療チームで定期的な振り返りを行い，スケールに対する共通の認識を持つ必要があると考えた．このスケー ルは症例間での意識レベルの比較が可能であり，高齢者への脳神経外科的な治療介入の効果を検討する際に有用と考えられた．"}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"谷口, 美季","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"濱内, 祝嗣","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"目黒, 俊成","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"福原, 徹","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"三好, 康之","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"小野, 成紀","creatorNameLang":"ja"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"TANIGUCHI, Miki","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"HAMAUCHI, Shuji","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"MEGURO, Toshinari","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"FUKUHARA, Toru","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"MIYOSHI, Yasuyuki","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"ONO, Shigeki","creatorNameLang":"en"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2022-04-01"}],"displaytype":"detail","filename":"KMJ-J202147023.pdf","filesize":[{"value":"1.0 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"PDF","objectType":"fulltext","url":"https://kwmed.repo.nii.ac.jp/record/2984/files/KMJ-J202147023.pdf"},"version_id":"a5bc9843-68a4-4e3e-8249-6007cb706a71"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"川崎意識障害回復スケール昏睡状態","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"最小意識状態","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"植物状態","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"脳内出血","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"Kawasaki Consciousness Recovery Scale","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Coma, Minimally conscious state","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Vegetative state","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Intracerebral hemorrhage","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"高齢者の脳内出血回復期における意識障害の分類 : 簡便なスケールの確立に向けて","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"高齢者の脳内出血回復期における意識障害の分類 : 簡便なスケールの確立に向けて","subitem_title_language":"ja"}]},"item_type_id":"10001","owner":"31","path":["800"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2022-04-01"},"publish_date":"2022-04-01","publish_status":"0","recid":"2984","relation_version_is_last":true,"title":["高齢者の脳内出血回復期における意識障害の分類 : 簡便なスケールの確立に向けて"],"weko_creator_id":"31","weko_shared_id":-1},"updated":"2024-04-19T04:22:02.286197+00:00"}